In this episode, Dr. Elizabeth Roche and registered nurse Micaela O’Donnell of the Elizabeth Roche M.D. MedSpa introduce the HALO TRIBRID laser and explain how it differs from HALO Hybrid and fully ablative CO2 treatments. They discuss the treatment experience, recovery and downtime, skin concerns and candidacy, and combining HALO TRIBRID with BBL and injectables. They also cover consultation planning, skin tones, sun exposure, and common patient questions.
Introducing HALO TRIBRID at Elizabeth Roche M.D. MedSpa
Dr. Elizabeth Roche: Hi everyone. Welcome to our laser discussion at the Elizabeth Roche M.D. MedSpa. I’m Dr. Roche.
Micaela O’Donnell: And my name is Micaela. I’m the registered nurse here.
Dr. Roche: And today we’re going to be talking about HALO TRIBRID laser. This is one of the newest lasers that we’ve brought to our office. Micaela, I, and our PA, Emily, we all perform this treatment and it’s been a very, very popular treatment. There’s been a lot of questions too, so we though we’d take the time today to discuss the laser in detail, but also to talk about why we brought this on to our office. Micaela, do you want to talk a little bit about how we decided to bring the HALO TRIBRID?
Micaela: Absolutely. We had such a variety of incredible skincare services to this point, but we felt like we were looking for kind of the next level. Dr. Roche has been using Sciton for over 20 years and she’s been staying up with the latest and greatest in terms of technology. And we have been really excited to bring TRIBRID on as their newest kind of, latest technology that provides us with something new that we can provide our patients.
HALO TRIBRID vs. HALO Hybrid: How the Laser Works
Dr. Roche: Yes. And now that we’ve been doing a lot of treatments over the past several months, we thought it’s a good time to answer those questions that some patients may have. So, let’s start with talking about how HALO TRIBRID differs from HALO Hybrid. You may have heard about HALO Hybrid. That was the first generation of the HALO laser and it incorporated two wavelengths. The difference with the TRIBRID is that it brings in a third wavelength, the 1927 wavelength that we’ll talk about more in detail, but that’s the MOXI wavelength. And combining all of these three wavelengths creates a beautiful treatment.
Micaela: Absolutely. And I think it was important that you were saying this, Dr. Roche, because it kind of helps fill in some of the gaps for certain patients that we feel may not be interested in some of our injectable services. And we have another phenomenal option for them to be able to address a lot of different concerns without necessarily having to go into injectables if it’s not something they’re interested in.
Dr. Roche: Absolutely. And also those patients who have been doing the BBL HERO / MOXI treatments.
Micaela: Absolutely.
Dr. Roche: And they want to take it to the next level. They’re looking for that next treatment. They’re really happy with their results, but they want to take it to the next level and that’s where the HALO TRIBRID comes in.
Micaela: Couldn’t agree more.
What Is HALO TRIBRID?
Dr. Roche: So let’s take it from the basics. Micaela, can you explain, as you would, what HALO TRIBRID is?
Micaela: Absolutely. So if I had to kind of summarize it, the most important points that I’d want to reiterate to my patients is explaining that it’s three wavelengths of light being emitted into the skin at the same time, synergistically working together to address all different layers of our skin, our most superficial aspects and our deeper aspects. So it’s a really incredible treatment that we’re able to work on such a large part of our skin.
What to Expect During HALO TRIBRID Treatment
Dr. Roche: Here’s a common question. What is the treatment like?
Micaela: How our patients would describe it that have done it to this point and said it’s a fairly streamlined treatment, meaning they come in, they topically numb for about 45 minutes to an hour. We take that part really seriously. We really want to make sure our patients are as comfortable as possible. And then we have a quick conversation, myself, Dr. Roche or Emily would have a quick conversation with the patient just to reiterate what we already discussed at our consult, just to make sure we were both on the same page prior to starting the treatment. And then it pretty much starts from there. It’s a fairly, like we said, efficient treatment. It would take us about maybe 15, 20 minutes in office depending on how many areas were being done.
Dr. Roche: That’s a good point. We can treat other areas besides just the face.
Micaela: Absolutely.
Dr. Roche: Neck, chest, and actually any body part that you’re concerned with.
Micaela: Absolutely. And I think a lot of our patients have taken advantage of that opportunity because they want to make sure they’re aging appropriately in every area of their skin, not just having their face age one way as their neck is aging another way. So I think that’s a really good kind of reminder for our patients too.
Dr. Roche: Right. They’re very comfortable throughout the procedure because as Micaela said, the strong topical numbing, a little bit of extra strength acetaminophen beforehand. Our machine has a cold Zimmer blower, cold air, and actually the patient is holding another tube of cold air if they need to. So it’s a very comfortable procedure. Can you describe what patients say it feels like?
Micaela: I would think the most common kind of theme we hear for patients is sunburn. I think a lot of patients describe it as they’ve felt in the past when they’ve gotten a sunburn or they’ve gone to the beach, they forgot their sunscreen that day, now they’re on the way back home and they’re starting to feel that heat component. I think that’s kind of what most of our patients have correlated what TRIBRID feels like is a sunburn.
Dr. Roche: Yeah, I agree. When we check in with them, they say after four or five hours it kind of all dissipated. And then the next day, most of them they say, “I’m in no pain at all. A little swollen, a little pink, a little red, but the pain component is not there at all. So it’s really nice.
Micaela: And we prepare them well. Dr. Roche has a fantastic skincare line that we utilize a product in particular for post-treatment to make sure our patients are recovering and handling that process appropriately.
HALO TRIBRID vs. Fully Ablative CO2 Laser Resurfacing
Dr. Roche: So one question we often get from our patients is how does HALO TRIBRID compare with the fully ablative CO2 laser?
Micaela: And I think this is a question we hear about a lot. CO2 laser has kind of gained some more popularity I think on things like social media. So a lot of our patients are asking, “Well, why is this special? Why is this unique compared to CO2?” How I try to explain it to patients is think of CO2 as kind of a full ablation, meaning a full resurfacing. We’re not leaving any healthy tissue behind. And why TRIBRID is so unique is it’s a fractionated technology. And what fractionated means is we’re leaving healthy tissue behind intentionally to help with the wound healing process. Where CO2’s wound healing unfortunately is a lot more involved because there’s no healthy tissue being left behind. So you have to re-epithelialize your entire surface of your skin again. And that’s where when we see some of these extreme photographs on social media, that’s unfortunately what it’s in regards to. So our TRIBRID patients will not have to deal, thank goodness, with anything like that.
Dr. Roche: Right. It takes a lot longer to recover from a CO2 laser than it would from the HALO TRIBRID.
Micaela: I couldn’t agree more.
HALO TRIBRID Recovery: Redness, Swelling, and Downtime
Dr. Roche: And I have a couple of patients when I’ve mentioned laser resurfacing, they would say, “Oh my gosh, my mom, when she had her facelift, had a laser peel. I don’t think I could ever go through that.” So it’s a lot of educating patients that this is so different. You’re getting even a better treatment with less down time. How about details of what the patient would feel in their skin, what they see, what they feel?
Micaela: And I think you gave a great summary of, like you were saying, redness is expected. I think swelling is something we constantly are reassuring our patients as part of that normal process.
Dr. Roche: Especially around the eyes.
Micaela: Absolutely. That area is such thin, delicate skin. We’re targeting it with this type of heat, it can cause a little bit of swelling, but we try to reiterate to our patients so swelling’s part of the process.
Dr. Roche: Exactly.
Micaela: It’s a good thing. At the end of the day, the goal that we set out for is going to be accomplished when we see some swelling and we see some redness and we see our skin starting to, what’s the word I’m looking for, exfoliate.
Dr. Roche: Exactly. Yes. Depending on how we set your treatment, it can happen around day three, day five, something like that. And it lasts around, I’d say most patients have seven days for recovery.
Micaela: I think that’s a good average.
Dr. Roche: Yeah. And by then, by day four or five, you could put makeup on. It may feel rough to the touch, but patients are putting their makeup on.
Micaela: Yes.
Dr. Roche: They’re going about their day. So it’s not like your skin is back to what it was before the treatment, but you can definitely function and go to the store, do some social events.
Micaela: Absolutely.
Dr. Roche: But you may have a little pinkness underneath that. And that roughness, it’s called microscopic epithelial necrotic debris. It’s the dead skin cells coming to the surface. That takes a few days, but it’s microscopic. Sometimes you have brown dots, absolutely, but it can be covered like little tiny microscopic dots. And by the week to 10 days, patients are great. So we often say, give us 10 days, we’ll give you 10 years back.
Who Is a Candidate for HALO TRIBRID?
Micaela: I love that. Absolutely. That’s a great way to sum up. Talk about who we would think is an ideal candidate for something like this.
Dr. Roche: Yes. I found that it’s great for patients who are older, who are looking for something to help with the tightening and the laxity we start to see in the 50s, 60s. And we’ve even had patients who are older than that come in for this treatment. So it addresses the collagen that starts to unravel as we age. So if you’re looking for something to help tighten up, something to resurface to help with fine lines and wrinkles, this is a great treatment. If you have stubborn sun spots, texture issues, and it’s also good for patients who’ve undergone facelifts. You’ve invested in a facelift, so you want to maintain that investment. So this is a great treatment to add to your repertoire of your skin routine throughout the years.
Micaela: I also think it’s important to talk about not only our corrective patients, that’s such an important aspect of our practice, but also utilizing conversations about our preventative patients. Some of our patients in maybe their 20s, their 30s, even younger 40s that are just looking to start that process and maintain how great they look, we know when they’re coming to us. And I think TRIBRID still fits into that role more than appropriately because we have such an ability to dial up in aggressiveness, how aggressive we want to treat that patient based on their skin concerns.
Dr. Roche: Right. Or someone’s just looking for that fresh polish. Agreed. That’s where the younger patients are coming in for that brightness.
Micaela: Absolutely.
Dr. Roche: It’s interesting to see that we are getting patients in their 20s and 30s specifically for this treatment.
Micaela: Yeah. I think everybody cares about their skin. Like you were saying, I think that’s something that’s so great about laser in particular is anybody can really benefit in terms of making their skin health better.
Customizing HALO TRIBRID for Different Skin Tones
Dr. Roche: That’s right. So it’s good for everybody, every age. The other thing too is with lasers, you have to be careful with the darker Fitzpatrick patients. And someone who doesn’t know what a Fitzpatrick skin scale is, it’s basically the tone or the coloring of your skin. And not all lasers are safe for every skin tone. However, with the HALO TRIBRID, we can adjust that so it is safe for all skin tones, Fitzpatrick’s 1 through 6. And sometimes it may require pretreatment, preconditioning of the skin. So that’s why it’s very important that we have patients come in for their consultation.
Micaela: Absolutely.
Dr. Roche: We look at their concerns and we come up with a plan pre-treatment, during the treatment and post-treatment as well.
Micaela: Absolutely. And I think our patients really appreciate that because it’s a plan that we’ve come up with specifically for them, their concerns, their downtime, and they know that we’ve put all of our attention specifically into them.
When to Postpone HALO TRIBRID Treatment
Dr. Roche: Absolutely. Okay. Here’s an important question. Is there anyone who should not get a HALO TRIBRID laser treatment?
Micaela: So even though we were saying anyone can benefit, there are a few considerations we always want to be mindful with. And one of the biggest ones is someone who’s pregnant. So a patient who’s pregnant, there is concerns with things like topical numbing. So again, the consultation’s a really important aspect of this treatment. You want to make sure that you’re having a conversation with one of the clinical team to make sure we’re bringing this treatment into your life at an appropriate time that works best for you.
Dr. Roche: Right. And there may be some medications such as isotretinoin, which is also known as Accutane.
Micaela: Absolutely.
Dr. Roche: We won’t want to treat you if you’re on that. An active infection, a severe sunburn, you’re going to have to postpone your treatment if you were just out in the sun or just got back from vacation and didn’t realize how much sun you received.
Micaela: Absolutely. I think you made another great point earlier of also how they heal. One of the biggest parts of this process is how you heal and we do our best to set you up to be successful. But if you have any type of medical history that involves issues with healing, that’s something you really need to know. We need to have a conversation about it prior to treatment.
Combining HALO TRIBRID with BBL and Injectables
Dr. Roche: How about this question? Can I combine this laser treatment with other treatments on the same day?
Micaela: Absolutely. Yeah. We actually, I think with a lot of our modalities here, it’s something that we really take pride in ourselves that we do utilize different treatments on the same day. From an efficiency standpoint, we understand our patients are doing a lot of things and sometimes if we can combine our treatments, doing it on the same day, it helps from a scheduling perspective and also helps with an impact perspective of their results. So it kind of works synergistically for the patient and for us. So yes, we absolutely pair this.
Dr. Roche: Just the other day I had a patient who came from afar and she had a laser treatment and we did neuromodulators and we did her dermal fillers all in the same appointment time. So that makes it very convenient for our patients. We also find that combining different laser treatments are very beneficial and sometimes patients will need broadband light or BBL treatment prior to their HALO TRIBRID laser, but many times we’re finding, especially in the fairer patients, they may have a lingering pinkness to their skin, so they benefit greatly by having a BBL treatment about four weeks after their HALO TRIBRID treatment.
Micaela: Absolutely. And the great part about BBL is a lot of our patients that have done it know that there’s not a lot of downtime. It’s quick, it’s a convenient appointment, and it’s something that not only will address some lingering redness as Dr. Roche mentioned, but you’re also getting so many great benefits from BBL traditionally. So it’s kind of like it’s helping you in your healing journey, but it’s also giving you a nice skin treatment as well.
Dr. Roche: Yeah, that nice glow.
Seasonal Planning and Sun Exposure for Laser Treatments
Micaela: Absolutely. One question I feel like we hear all the time is what is the best time of year to have this treatment? And I think Dr. Roche kind of already brought this up of being mindful of your sun exposure prior to treatment, but I think some of the best times of year that are easiest are the fall and winter.
Dr. Roche: Right. It’s laser season!
Micaela: Exactly.
Dr. Roche: We’re very busy today. I mean, every day of the fall.
Micaela: Absolutely.
Dr. Roche: We are filming this in the fall and we’ve just been really busy doing several of these treatments every day.
Micaela: Totally.
Dr. Roche: I’ve got to get this machine back into the room!
Micaela: Oh great. So then we get back to treating our patients. But the good news is, too, I think Dr. Roche always reiterates this beautifully in her consultations, is patients can do this year round as well. These devices are sold all across the country, all across the world. Patients can utilize these incredible treatments during those summer months. You just have to have that conversation with your clinical team member to make sure it’s appropriate and whatnot. But this is something you could do year round depending on the person that you are and the concerns that you have.
HALO TRIBRID FAQs: Downtime, Makeup, and Comfort
Dr. Roche: Right. Okay, this is rapid fire, one sentence answers reiterating some of the important questions.
Micaela: Perfect.
Dr. Roche: How long is the downtime?
Micaela: 7 to 10 days I think is a good kind of average rule of thumb. So when can our patients wear makeup again, Dr. Roche?
Dr. Roche: Anywhere from 2 to 4 days, depending on the density. Is it painful?
Micaela: No. I have to start and say no, because we do too many things here to make sure your pain is under control. So I would have to say no. What would you say, Dr. Roche, is one of the most common things you hear about after the treatment has been performed?
Dr. Roche: My skin looks incredible. My skin looks radiant. That was so easy. Why didn’t I do this earlier?
Micaela: Couldn’t agree more. Or when can I get my next area is pretty much another one.
Dr. Roche: Yes. Or when should I schedule my next one?
Micaela: Absolutely.
Dr. Roche: We hear that all the time.
Schedule a HALO TRIBRID Consultation
Dr. Roche: So if you are listening and you’re curious about learning more about HALO TRIBRID and if it’s appropriate for you, we encourage you to go on the website, www.elizabethrochemedspa.com. Follow us on Instagram @dr.roche, and call us, and we would love to schedule you for a consultation and come up with a treatment plan. Any closing words, Micaela?
Micaela: I think you summarized it perfectly, Dr. Roche. We would love the opportunity to meet with you. We hope you can come in for a consultation and learn more about this incredible laser.
Dr. Roche: Thank you so much for joining us today.
Micaela: Thank you guys so much. Looking forward to meeting you all in office soon.